Survival Analysis of Living Arrangements and Health Care Utilization in Terms of Total Mortality Among the Middle Aged and Elderly in Taiwan

Abstract

The purpose of this study was to use survival analysis to examine the influence of living arrangements and health care utilizations on total mortality among the middle aged and elderly in Taiwan. A panel data design was applied to data to investigate whether living arrangements and health care utilizations were associated significantly to survival rates in the middle aged and elderly. Subject data was obtained from the Survey of Health and Living Status of the Middle Aged and Elderly in Taiwan, a study conducted in 1996 that encompassed observations on 2,462 individuals 50 years of age and older. Survey data was linked to 1996-2003 national death registry data. A Cox proportional hazard model was used to determine the relationship between mortality rate and age, gender, living arrangements and health care conditions. Principal empirical results confirmed that, after controlling for potentially confounding variables, the relatively younger elderly had a higher survival rate during the period 1996 to 2003. Females also had a longer life span than males in the same period. In addition, when other factors were excluded, this paper highlights that the middle aged and elderly living with their spouse and children enjoyed a significantly higher survival rate than those who lived alone. Furthermore, the findings showed that purchase of medicine (Chinese and/or Western) was positively correlated with survival rate and a lower survival rate for those with longer hospital stays and higher numbers of clinic visits. Findings suggest that living arrangements and health care utilization variables have strong and significant influences on the mortality rates for the middle aged and elderly. Research results should be useful in developing welfare strategies targeting living arrangement and health care services for the target group.

Life History and Risk of Death after 50: A Survival Analysis for Europe

“…The results, including the current information on the respondents and demographic characteristics, are in line with the literature. In our research sample, men died at younger ages than women, and older respondents were signifi cantly more exposed to the risk of death than younger individuals (for similar results see, e.g., Ho, 2008 ;Buckley, Denton, Robb, & Spencer, 2004 ). The impact of the place of residence and education is insignifi cant.…”

Association of providing/receiving support on the mortality of older adults with different living arrangements in Taiwan: a longitudinal study on ageing

“…The results of these two studies are consistent with Taiwan's traditional mores which encourage older adults to live with their children or grandchildren and care for one another. In fact, Asian countries frequently lack a comprehensive elderly care social welfare system, which leads to most people in their later lives depending on their family, especially their children (Ho 2008 ).…”

Place of residence before hospital admission and mortality at 12‐months in Spanish patients aged 70 years or older

“…Subsequently, it has been proposed that there is no reason to assume that living alone is a risk factor, necessarily harmful to an older person's health 18 . In this regard, current literature shows dissenting results influenced by sociocultural context: living in their own home or alone is presented as an advantage in Western societies, 19,20 whereas the highest survival rates are observed in people living with their relatives in Asian societies 21 …”

“…18 In this regard, current literature shows dissenting results influenced by sociocultural context: living in their own home or alone is presented as an advantage in Western societies, 19,20 whereas the highest survival rates are observed in people living with their relatives in Asian societies. 21 Although there are multiple causes of living arrangement transitions, chronic illnesses and functional abilities are among the major determinants of these changes, with a lesser influence of socioeconomic factors. 20 Similar to recent observations regarding primary care utilization, 18 it is possible that living arrangements Prior residence and 1-year post-discharge mortality © 2012 Japan Geriatrics Society ͉ 699 influence hospital use, conditioning different morbidity levels at hospital admission and leading to different health outcomes during hospitalization.…”